HPV Test

An HPV test is an STD test that looks for DNA or RNA from particular strains of human papillomavirus (HPV) that have been linked to cervical cancer.

These high-risk HPV strains can also cause cancers of the anus, vagina, vulva, penis, and oropharynx, among other things.

An HPV test is similar to a pap smear, and involves swabbing the cervix with a specialized swab to collect cells. The cells are then analyzed in a lab, looking for DNA that is specific to certain strains of HPV.

According to the CDC, an HPV test may be conducted in the following circumstances:

• Cervical cancer screening. Lab tests check for cancer and precancerous abnormalities before symptoms appear; early discovery makes treatment more likely to be successful. The majority of cervical cancers are caused by HPV, and testing enables individuals infected with high-risk HPVs to be efficiently monitored and aberrant cervical cells to be eliminated before they become malignant. Everyone with a cervix can be checked, including women and transsexual men.
• OB-GYN follow-up. An HPV test may be ordered by an OB-GYN or primary care provider following an abnormal pap smear or presence of other symptoms.
• Treatment planning for oropharyngeal cancer. Oropharyngeal cancer is one that develops in the tonsils or the back of the throat. The majority of oropharyngeal malignancies are caused by HPV. Since HPV-positive oropharyngeal malignancies may require different treatment than HPV-negative oropharyngeal cancers, HPV testing is an important aspect of treatment planning.

What's measured by a HPV test?

An HPV test looks for the presence of the human papillomavirus, as well as the specific strain of HPV.

When should I get a HPV test?

You may need an HPV test if you are a female between the ages of 30 and 65, according to the National Library of Medicine (NLM). It adds that you may also need it if you are female and receive an abnormal result on a Pap smear, regardless of how old you are.

Females who think they have been exposed to HPV, or who are having symptoms of HPV, should also consider getting an HPV test.

According to the CDC, symptoms of HPV may include:

• genital warts
• lumps
• sores

HPV testing is not recommended for females under the age of 30 who have normal pap smear results.

The NLM says HPV infections are common, though cervical cancer is rare among females in this age group. It adds that most HPV infections in females under 30 usually clear up on their own without treatment.

Planned Parenthood says it's ideal to get an HPV test every five years if you are between the ages of 25 and 65, and that an HPV test may not be necessary after you turn 65.

It adds that the frequency at which you get tested for HPV usually depends on your age, medical history, and results of your last HPV or Pap tests.

If you have a weakened immune system or a history of cervical problems, your healthcare provider may recommend getting tested for HPV more frequently.

You may also need frequent HPV testing if your mother took a medicine called DES while she was pregnant with you, adds Planned Parenthood. Your provider can recommend the frequency at which you should have an HPV test based on these and other factors.

What to expect with a HPV test

An HPV test is performed exactly like a Pap smear, says the ACS. Your healthcare provider will use a special tool or swab to remove cells from your cervix so they can be tested for HPV.

First, your provider will ask you to lie on your back on an exam table and bend your knees, says the NLM. You may be asked to place your feet in stirrups; lacing your feet in stirrups will help you be more comfortable, as well as help the healthcare provider have the best access to perform the test.

Your provider will use an instrument called a speculum to help get a clearer view of your cervix. Your provider will then use a swab or other tool to collect a small sample of cells from your cervix.

Afterward, your sample will be evaluated in a lab to determine whether you have HPV.

How to prepare for the test

Prior to an HPV test, NIH recommends that you should do the following to prepare:

• avoid having sex (you should always avoid sexual contact if you think you may have an sti or have symptoms of an infection)
• avoid douching for at least 24 hours before taking a test, as douching can wash away the vaginal cells and/or fluids required for the test
• avoid using deodorant products or cleansers on your genital area, as such products can worsen irritation and mask signs that help your doctor diagnose the infection
• avoid using tampon, vaginal medicines and birth control foams for two days prior to testing

The NIH further recommends trying to schedule in-office HPV testing when you don't have your period, if possible. However, do not cancel or reschedule your appointment if you get your period. The test will not be affected by your period, and it is best to be tested than to wait.

If you're taking an at-home test that requires a vaginal swab, it's best to perform the swab when you're not menstruating, in accordance with the testing kit's instructions.

Contact the HPV test provider if you have concerns or questions regarding what you should and shouldn't do before your test. Your healthcare provider may give you other suggestions to help ensure your test results are accurate.

After the test

Following a HPV test, there are no special instructions or limitations.

HPV test results

Your HPV test results will come back as either negative or positive, or as normal or abnormal. In most instances, your provider will contact you with your results when they are ready. Some providers may only contact you if your results come back positive.

Be sure to ask about how to learn about your HPV test results during your appointment.

Negative HPV test results

Results that are negative or normal mean that you do not have a high-risk strain of HPV, reports the NLM. It adds that your healthcare provider may recommend coming back for another HPV test in five years or sooner based on your medical history and age.

Positive or abnormal HPV test results

Results that are positive or abnormal indicate that you have a high-risk strain of HPV, notes the NLM. This means you may be at higher risk for developing cervical cancer at some point in the future.

If your HPV test results are positive, your healthcare provider will likely recommend coming back in so your abnormal cells can be treated or removed before they turn into cancer.

Your provider may also ask you to come in more frequently for regular screenings so any abnormal cell activity can be closely monitored.

Positive or abnormal HPV test results may also lead to further testing to confirm whether or not you already have cancer. Colposcopy and cervical biopsy are examples of procedures your provider may perform to examine your condition, reports the NLM.

During a colposcopy, your provider will examine your vagina and cervix using a special magnifying tool called a colposcope. During a cervical biopsy, your provider will take a small sample of tissue from your cervix and examine it under a microscope.

The NLM adds that in many instances, HPV will clear up on its own without treatment.

Finding a HPV test

Generally your primary care provider or OB-GYN will order an HPV test, which will usually take place either in their office setting or at the hospital.

Can I get a HPV test at home?

Yes, at-home HPV tests are available. Discrete at-home HPV tests test for high-risk HPV infections using a swab for women or a urine sample for men.

While convenient, at-home HPV testing is not as comprehensive as tests performed in a clinical setting and therefore do not differentiate among high-risk types and results will simply show "detected" or "not detected." Additionally, they are not a substitute for cervical cancer screening.

The CDC does not recommend home tests for anyone who has active symptoms or who has had sexual contact with someone who has tested positive for HPV. This is because home tests will need to be sent to a laboratory, and results can take several days.

If you are at high risk for HPV, the CDC recommends that you be tested by a doctor near you so that you can begin treatment as soon as possible.

Cost of an HPV test

The cost of an HPV test ranges from $15 to $159; however, the final cost of a HPV test will vary depending on your location and insurance coverage.

Being tested for other STDs at the same time may also increase the cost. An office visit and laboratory fees may be separate costs.

More information about HPV

What is HPV?

HPV stands for "human papillomavirus". It is a very common virus that spreads by skin-to-skin contact with someone who is infected.

HPV is the most common STI, with more than 40 million cases reported to the CDC in 2018. The CDC also notes that almost every sexually active person will come in contact with a strain of HPV at some point.

There is a vaccine available that prevents more than 90% of HPV-related cancers.

HPV symptoms to watch for

The most common symptom of HPV is genital warts, which may be difficult to see or feel. Per the CDC, most people will not know they have HPV unless they develop genital warts or have an abnormal pap smear. HPV symptoms to watch for are:

• genital warts on the vulva, labia, anus, penis, or inside the vagina
• common warts on the hands or fingers
• plantar warts on the bottom of feet